r
FEC
FORM 1
STATEIUIENT
OF
ORGANIZATION
PAGE
/ 4
RECEIVED
Office Use Only
Example:If typing, type
12FE4li^
MAIL' UhN 11^^ over the lines. 1.
NAME
OF
COMMITTEE
(in
full)
(Check if name is changed)
McSally
Tobin Rogers Ducey Victoiy Coininittee (MTRDVC)
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1
ADDRESS
(number and street) ,2532 N 4th St i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ^ (Check if address is changed)
.Ste
528 1 1 1 1 1 1 1 1 i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 .1 1 1 1 ^ (Check if address is changed) . Flagstaff 1 1 1 1 1 1 1 1 1 1 1 1 1
1 , . < , 1 1*^ 1
,86004 1 i 1
1 1 I-I 1 1 1 1
CITY
A
STATE
• ZIP
CODEA
COMMITTEE'S
E-MAIL
ADDRESS
(Check if address ,dsmith@nrreports.net
is changed) I I I I I I I I I
I I I i I I I I I I ' I '
Optional Second E-Mail Address I I I I I I I I I I I I I I I I I I I I I I I I
I I I I I
COMMITTEE'S
WEB
PAGE
ADDRESS
(URL) ^ (Check if address is changed)
I I I I I I I I I I I I I I ' I
I I I I I I I I I I I I I I I I I I I I
2.
DATE
MM/OD/VYYV
04 23 2014
3.
FEC IDENTIFICATION
NUMBER
• C
4.
IS THIS
STATEMENT
X NEW (N) OR
AMENDED
(A) I certify
that
I have examined this Statement and to the best of my knowledge and belief it is true, correct and complete. Type or Print Name of Treasurer Donna Smith Signature of Treasurer
Donna Smith
Date
M
M / d D / Y ' Y Y Y
04 23 2014
NOTE:
Submission of false, erroneous, or incomplete information may subject the person signing this Statement to the penalties of 2
U.S.C.
§437g.
ANY
CHANGE
IN
INFORMATION
SHOULD
BE
REPORTED
WITHIN 10
DAYS.
L
Office
Use
Only
For
further Infbrmation
contact:
Federal
Election Commission
Toll Free 800-424-9530
Local
202-694-1100
FEC
FORM
1
(Revised 06/2012) j
r n
FEC
Form 1 (Revised 02/2009)
Page
2
5 TYPE OF
COMMITTEE
Candidate Committee:
(a) This committee is a principal campaign committee. (Complete the candidate information below.) (b) This committee is an authorized committee, and is NOT a principal campaign committee. (Complete the candidate infbrmation below.) Name of
Candidate
I i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i
Candidate Office • State Party Affiliation Sought: House Senate President District
II
(c) This committee supports/opposes only one candidate, and is NOT an authorized committee. Name of Candidate I i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i I
JP
Party
Committee:
(National, State (Democratic, (d) This committee is a or subordinate) committee of the Republican, etc.) Party.
Poiiticai
Action
Committee
(PAC):
(e) This committee is a separate segregated fund.
Identify
connected organization on line 6.) Its connected organization is a: Corporation Corporation w/o Capital Stock Labor Organization Membership Organization Trade Association Cooperative in addition, this committee is a Lobbyist/Registrant
PAC.
(f) This committee supports/opposes more than one Federal candidate, and is NOT a separate segregated
fund
or party committee, (i.e., nonconnected committee) In addition, this committee is a Lobbyist/Registrant
PAC.
In addition, this committee is a Leadership
PAC.
Identify
sponsor on line 6.)
Joint Fundraising
Representative:
(g) s/ This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political committees/organizations, at least one of which is an authorized committee of a federal candidate. (h) This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political committees/organizations, none of which is an authorized committee of a federal candidate.
Committees Participating in Joint Fundraiser
iTPT ?9^Pf
ID number Q C0055«,12
2.
DUCEY2014 I I . r>
I I I J " I I I I I I I I I I I I I I I I FEC ID number Q
4.
.WENDYROGERS.ORG
i , i i , ccr .n K O rnn^inQ..« I [ I I I j I [ I I I I I I I I [ I [ [ I I I FEC ID number Q C00510958
L
J
r
FEC
Form 1 (Revised 02/2009)
Page
3 Write or Type Committee Name
McSally Tobin Rogers Ducey Victoiy
Coininittee (MTRDVC)
6
Name
of Any
Connected Organization,
Affiliated
Committee, Joint Fundraising Representative,
or
Leadership
PAC Sponsor
NONE
.
Mailing Address
CITY
UJ
L
STATE
LJ-|
I I I ZIP
CODE
Relationship: Connected Organization Affiliated Committee Joint Fundraising Representative
Leadership
PAC
Sponsor 7. Custodian of Records:
Identify
by name, address (phone number -- optional) and position of the person in possession of committee books and records. Donna Smith
Full
Name I
I II
Mailing Address .45 N Hill Dr
i I I I I
I I I I I
,Ste
100 I I I I I I I I I I I I I I I I I I I I I I I I I I Warrenton
VA
, .20186 I I I I 1 I I I I
^-|__L
Title or Position
CITY
STATE
ZIP
CODE
Treasurer
I I I I I I I I I I I
Telephone number 540 341
-LJ-
8808 8. Treasurer: List the name and address (phone number - optional) of the treasurer of the committee; and the name and address of any designated agent (e.g., assistant treasurer).
Full
Name Donna Smith of Treasurer I i i i i
I I I I I I I I I I I I I I I I I
Mailing Address 145 N Hill Dr I I I I I I I
II I
I
Ste
100 I I I I I I I I I I I I I I I I I I I Warenton I I I I I II
CITY
VA
I 120186
STATE
Title or Position I Treasurer I I I I I I
I I I I I I I I
Telephone number 540 I I I I I I I
I I I I I I I I I I ' I I
I I I" I I I ZIP
CODE
341 , , 8808 I I I
L
J